Organization Active NPI

John H Lee DMD PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Smithtown, NY
National Provider Identifier
1710140116
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
050381 Issued in NY
Legal business name
JOHN H LEE DMD PC
Practice address
80 Maple Avenue
Suite 208
Smithtown, NY 11787
Phone
(631) 724-7575
Fax
(631) 724-4790
NPI assigned
Jul 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John H Lee, DMDNPI 1174652986
Title
Owner
Phone
(631) 724-7575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 050381 NY Primary

Addresses

Primary practice location

80 Maple Avenue
Suite 208
Smithtown, NY 11787

Mailing address

80 Maple Avenue
Suite 208
Smithtown, NY 11787
Phone (631) 724-7575

Other identifiers 1

IdentifierTypeStateIssuer
02602528MedicaidNY

National Provider Directory

National Provider Directory

Locations

80 Maple Ave
Ste 208
Smithtown, NY 11787
Phone (631) 724-7575

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1710140116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MAPLE AVENUE",
            "address_2": "SUITE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-724-7575",
            "fax_number": "631-724-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAPLE AVENUE",
            "address_2": "SUITE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-724-7575",
            "fax_number": "631-724-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN H LEE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-724-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "050381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02602528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.